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General NPI Number Information
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NPI Number | 1063168268
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Entity Type | Individual
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Provider Name | TAMMY R LEE AGNP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2022
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1818 WASHINGTON BLVD STE F
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City | BELPRE
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State | OH
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Zip | 45714-2080
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Country | US
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Telephone | 740-423-3640
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Fax | 740-423-3641
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Provider Business Mailing Address
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Address Line | 1315 TOWER RD
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City | LITTLE HOCKING
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State | OH
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Zip | 45742-5267
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Country | US
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Telephone | 740-818-8579
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AGNP.CNP.0030870
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License Number State | OH
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